7 Medicines and Pharmacology Flashcards

1
Q

Requirements for skin absorption

A

Based on lipid solubility through the epidermis

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2
Q

Requirements for CSF absorption

A

Non-ionized, lipid-soluble drugs

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3
Q

Why can you not use sulfonamides in newborns?

A

Displaces unconugated bilirubin from albumin in newborns

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4
Q

Where are tetracycline and heavy metals stored?

A

Bone

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5
Q

0 order kinetics?

A

Constant amount of drug is eliminated regardless of dose

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6
Q

1st order kinetics?

A

Drug eliminated proportional to dose

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7
Q

How long does it take for a drug to reach a steady state?

A

5 half-lives

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8
Q

Volume of distribution?

A

Amount of drug in the body divided by the amount of drug in plasma or blood

Drugs with high VOD have higher concentrations in extravascular compartment (i.e. fat tissue) compared to intravascular concentrations

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9
Q

Bioavailability

A
Fraction of unchanged drug reaching the systemic circulation
IV drugs - 100%
PO drugs (less)
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10
Q

ED50

A

Drug level at which desired effect occurs in 50% of patients

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11
Q

LD50

A

Drug level at which death occurs in 50% of patients

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12
Q

Hyperactive

A

Effect at an unusually low dose

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13
Q

Tachyphylaxis

A

Tolerance after only a few doses

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14
Q

Potency

A

Dose required for effect

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15
Q

Efficacy

A

Ability to achieve results without untoward effect

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16
Q

Phase I drug metabolism

A

Hepatocyte smooth endoplasmic reticulum
Demethylation, oxidation, reduction,hydrolysis reactions
Mixed function oxidases
Requires NADPH/oxygen

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17
Q

Phase II drug metabolism

A

Hepatocyte smooth endoplasmic reticulum
Glucuronic acid and sulfates attached
Forms water-soluble metabolite - usually inactive and ready for excretion
Biliary excreted drugs may become deconjugated in intestines with reabsorption, sometimes in active form

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18
Q

Inhibitors of P450

A
Cimetidine
Isoniazid
Ketoconazole
Erythromycin
Cipro
Flagyl
Allopurinol
Verapamil
Amiodarone
MAOIs
Disulfiram
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19
Q

Inducers of P450

A
Cruciform vegetables
ETOH
Insecticides
Cigarette smoke
Phenobarbital (barbiturates)
Dilantin
Theophylline
Warfarin
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20
Q

Polar drugs

A

Ionized
Water soluble
More likely to be eliminated in unaltered form

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21
Q

Nonpolar drugs

A

Non-ionized
Fat soluble
More likely metabolized before excretion

22
Q

Gout

A

Uric acid buildup
End product of pruine metabolism
Tx: Colchicine, Indomethacin, Allopurinol, Probenecid

23
Q

Colchicine

A

Anti-inflammatory
Binds tubulin and inhibits migration of WBCs
For Gout

24
Q

Indomethacin

A

NSAID
Inhibits prostaglandin synthesis (reversible cyclooxygenase inhibitor)
For Gout

25
Q

Allopurinol

A

Xanthine oxidase inhibitor
Blocks uric acid formation from xanthine
For Gout

26
Q

Probenecid

A

Increases renal secretion of uric acid

For gout

27
Q

Cholestyramine

A

Binds bile acids in gut - forcing body to make more bile acids from cholesterol
Can bind vitamin K and cause bleeding tendency
For hyperlipidemia

28
Q

Statins

A

HMG-CoA reductase inhibitors
Can cause liver dysfunction, rhabdomyolysis
For hyperlipidemia

29
Q

Niacin

A

Inhibits cholesterol synthesis
Can cause flushing (Treat with ASA)
For hyperlipidemia

30
Q

Promethazine (Phenergan)

A

Antiemetic
Inhibits dopamine receptors
AE: Tardive dyskinesia (treat with benadryl)

31
Q

Metoclopramide (Reglan)

A

Prokinetic
Inhibits dopamine receptors
Can be used to increase gastric and gut motility

32
Q

Ondansetron (Zofran)

A

Antiemetic

Central-acting serotonic receptor inhibitor

33
Q

Omeprazole

A

Anti-acid
Proton pump inhibitor
Blocks H/K ATPase in stomach parietal cells

34
Q

Ocretotide

A

Long-acting somatostatin analogue

Decreases gut secretions

35
Q

Digoxin

A

Inhibits Na/K ATPase - increasing myocardial calcium
Slows atrial-ventricular conduction, ionotrope
AE: Decreases blood flow to intestines - mesenteric ischemia; Hypokalemia (precipitate arrhythmias/AV block); yellow hue, fatigue, arrhythmias
NOT cleared by dialysis

36
Q

Amiodarone

A

Good for acute atrial and ventricular arrhythmias

AE: pulmonary fibrosis with prolonged use, hypo/hyperthyroidism

37
Q

Magnesium

A

Used to treat torasdes de pointes (ventricular tachycardia)

38
Q

Adenosine

A

Causes transient interruption of the AV node

39
Q

ACE inhibitors

A

Can prevent CHF after MI
Can prevent progression of renal dysfunction in HTN, DM
Can precipitate renal failure in renal artery stenosis

40
Q

Best single agent to improve survival in patients with CHF

A

ACE inhibitors

41
Q

Beta-blockers

A

Improve survival in severe LV failure

Reduces risk of MI and afib postoperative

42
Q

Best single agent to improve survival in patients after MI

A

Beta-blockers

43
Q

Atropine

A

Acetylcholine antagonist

Increases heart rate

44
Q

Metyrapone

Aminoglutethimide

A

Inhibits adrenal steroid synthesis

Used in patients with adrenocortical CA

45
Q

Leuprolide

A

Analogue of GnRH and LHRH
Inhibits release of LH and FSH from pituitary when given continuously
Used in patients with metastatic prostate cancer

46
Q

NSAIDs

A

Inhibit prostaglandin synthesis and leads to decrease in mucus and HCO secretion and increased acid production

47
Q

Misoprostol

A

PGE1 derivative
Protective prostaglandin
Consider use in patients on chronic NSAIDs

48
Q

Haldol

A
Antipsychotic
Inhibits dopamine receptors
Extrapyramidal cells (treat with benadryl)
49
Q

ASA poisoning

A
Symptoms:
Tinnitus, headaches, nausea, vomiting
1st - respiratory alkalosis
2nd - metabolic acidosis
Treatment - supportive
50
Q

Most common adverse effect of gadolinium

A

Nausea

51
Q

Most common side effects of iodine contrast

A

Nausea

requiring medical treatment - dyspnea

52
Q

Treatment of tylenol overdose?

A

N-acetylcysteine